Expert standard (care)
An expert standard (nursing) is an instrument that is intended to guarantee the quality of nursing and represents the current state of science and research on the respective nursing topic. They combine current nursing scientific and nursing practical knowledge and define nursing goals and measures . Expert standards are issued by the German Network for Quality Development in Nursing (DNQP).
Creation of an expert standard
Each expert standard goes through a four-stage process
development
First, a relevant topic is sought and a systematic literature search is carried out, in which all important publications on the topic are examined and evaluated by an independent group of experts. This evaluation and the discussion about it is the basis of the expert standard. The points found in the literature and the selection of literature are justified in writing and result in the first draft of the new expert standard.
Consensus building
In this phase, the first draft of the expert standard is presented to the specialist public, usually in the context of various conferences. Nurses from science and practice have the opportunity to comment on or add to the draft. These are in turn discussed by the expert group and adjusted if necessary. The resulting reprint of the expert standard is not yet complete because the implementation is missing.
implementation
After the offprint has been published, the new expert standard will be tested in around 25 different care facilities based on a standardized concept. The practicability and acceptance by those involved in the care are checked. In addition, research is being carried out into which requirements are necessary for a sustainable introduction in different care environments. If necessary, the expert standard is adapted to the results of the implementation. The complete expert standard with all components and results is then published.
Update
The expert standard will be updated no later than five years after the final publication. The period can be extended to seven years if, in exceptional cases, an early update has taken place.
construction
All expert standards have the same structure and can be divided into three areas.
Structural criteria
This section describes the prerequisites that must be present so that the expert standard can be implemented. A distinction is made between
- Nursing skills
- Caregiver responsibility
- Caregiver Responsibility
- Care facility resources
- Framework conditions of the care facility
Process criteria
These criteria describe the necessary competencies and resources of the nursing staff and how the expert standard can be implemented.
Result criteria
Result criteria by which one recognizes the successful implementation of the expert standard.
format
The most important part of the expert standard is understood to be a one-sided matrix in which the structure, process and result criteria are clearly presented. These are the part of the expert standards that can be freely accessed on the DNQP website. The comprehensive expert standard with all explanations for the development, the criteria as well as the comments, literature study and the audit instrument is chargeable.
Available expert standards
- Pressure ulcer prophylaxis in nursing
- Discharge management in nursing
- Pain management in care for acute pain
- Pain management in care for chronic pain
- Fall prevention in care
- Promotion of urinary continence in care
- Caring for people with chronic wounds
- Nutritional management to secure and promote oral nutrition in care
- Promote physiological childbirth
- Relationship creation in the care of people with dementia
- Maintaining and promoting mobility
Legal obligation
In order to be legally binding, expert standards according to Section 133a (3) SGB XI must be published in the Federal Gazette , but no expert standard has yet been published. However, in accordance with Section 11 (1) SGB XI, care institutions must work in accordance with the generally recognized state of medical and nursing knowledge. For the Medical Service of the Health Insurance Funds (MDK), the expert standards are one of the bases for evaluating care facilities. and are considered to serve as "anticipated expert reports" in the event of legal disputes.
criticism
The expert standards are viewed critically in nursing practice despite their advantages as an essential contribution to increasing quality and professionalization. In some cases, the expert standards do not match the conditions on site, and known problems often arise in the implementation in outpatient care . Another critically viewed aspect is that an appropriate introduction often requires both more and better qualified personnel. Additional financial resources must also be raised for advanced training on expert standards, because every expert standard should be deepened in training when it is introduced in order to be able to meet the requirements of the MDK and home supervision , for example.
literature
- Barbara Messer: The expert standards in everyday care Schlütersche, 2007 ISBN 978-3899931846
- Simone Schmidt: Expert standards in care: Instructions for use Springer, 2009 ISBN 978-3642013225
Web links
Association of Substitute Funds: Expert Standards in Nursing Status: November 4, 2019, accessed on June 30, 2020
Individual evidence
- ↑ Barbara Messer: The expert standards in everyday care Schlütersche, 2007 ISBN 978-3899931846 p. 14
- ↑ Barbara Messer: The expert standards in everyday care Schlütersche, 2007 ISBN 978-3899931846 pp. 20-21
- ↑ MDK: Guidelines of the National Association of Statutory Health Insurance Funds on the examination of the services provided in care facilities and their quality according to §114 SGBXI (PDF)
- ↑ Simone Schmidt: Expert standards in care: Instructions for use Springer, 2009 ISBN 978-3642013225 pp. 6-7